Personal Statement

I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more

I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.

More about Dr. A Joshi

Dr. A Joshi is an experienced Endocrinologist in Rasta peth, Pune. You can meet Dr. A Joshi personally at KEM Hospital - Pune in Rasta peth, Pune. Book an appointment online with Dr. A Joshi and consult privately on Lybrate.com.

Lybrate.com has top trusted Endocrinologists from across India. You will find Endocrinologists with more than 43 years of experience on Lybrate.com. You can find Endocrinologists online in Pune and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Hello
You have Hypothyroid, and you are on medications, yet there is enlargement of the gland.
I would like to know your TSH and FT4 level, and your anti TPO antibody test report, . Once you have this further line of managment can be decided and modifeid accordingly
Thanks
Dr Joozer

Dear, According to Ayurveda There are 20 forms of Diabetes : 4 are due to Vata, 6 result from Pitta, and 10 are caused by Kapha. But Diabetes (MADHUMEHA) is.Mainly kapha dosha disease. Poorly managed diabetes can lead to a host of long-term complications like :-
Heart attacks, Strokes, Blindness, Nerve damage, Amputation of Limb. Impotency in men.Visit us at www.Malhotraayurveda.Com

Hello Mr. Lybrate-user no as you asked about your problems related to your nervous system and unknown fearing are relatively linked with your nervous system and anxiety, depression. I would like to advise you to follow regular daily routines of getting all dietary measures and daily behaviours as well as exercise and yoga. You may learn yoga from any yoga teacher and practice daily. However you may engage yourself in any work. You may practice meditation twice daily then you feel better result.

Dear its a nice thing about you having concern about your diabetic mother. Kindly answer me about her age in my personal column. Diabetes is not a disease. Only problem is under wrong treatment she may suffer problems. I mean the first stage of the disorder leads to weakness, lax muscles. Joints also may be painful. Kindly take care of her feet and eyes. Kindly check her vitd3 and vit b12. Give her capsules of vit and zinc.

I would like you give me some more details like fasting & pp blood sugar levels, hba1c level, lipid profile and medicines being taken. From your explanation it appears that diabetes control is not good. The swellings that you have mentioned are they red, pointing and painful on touch, if so they must be furruncles and on top this if you have developed foot ulcer then it is more serious matter. If you are not on insulin already, please start it straight away with your doctor's advise. If surgery is advised please get it done. Only antibiotics may not be able to resolve the matter.

Sugar-free pills have till date not undergone any major human study trial. By doing human study trial we ascertain the benefits and risks of any agent on scientific basis. So in reality everybody is consuming these sweeteners on the basis of animal trials !

Hi lybrate-user,
thyroid levels may change in pregnancy & it is advisable to take proper medications to control them as they may affect the baby's brain & other organ development. Please follow your doctor's advise.

HbA1c alone is sufficient as a marker of good diabetes controlChronic hyperglycemia is captured by A1c but not by FPG (even when repeated twice).Microangiopathic complications (retinopathy) are associated with A1c as strongly as with FPG.A1c is better related to cardiovascular disease than FPG.Fasting is not needed for A1c assessment.No acute perturbations (e.G, stress, diet, exercise, smoking) affect A1c.A1c has a greater preanalytical stability than blood glucose.A1c has an analytical variability not inferior to blood glucose.Standardization of A1c assay is not inferior to blood glucose assay.Biological variability of A1C is lower than FPG and 2-h OGTT PG.Individual susceptibility to protein glycation might be caught by A1c.A1c can be used concomitantly for diagnosing and initiating diabetes monitoringNatural history of T2DM in Asia******************************************Diabetes is a global epidemic which is out of control, but worse in Asian countries.It is a huge and growing problem and costs to the society are high and escalating.Five countries from Asia figure in the top 10 and account for most cases of diabetes globally.Asian countries share similar risk factors.There is an association between economic growth and diabetes.Rapid urbanization and modernization obesogenic environment i.E. Physical inactivity, psychosocial stress and abundance of foodAsians are prone to developing diabetes at a lower level of obesity.Diabetes has the potential to negatively impact economy and may bankrupt healthcare systems.Cost effective interventions in healthy living and diet decrease the burden of diabetes and save on healthcare costs and lost productivity.There has been a dramatic rise in the number of diabetic population in Korea: economic growth, greater exposure to risk factors (lifestyle and diet), demographic changes (childhood obesity, aging population).Hypertriglyceridemia: The most difficult lipid disorder to evaluate and treat-----------------------------------------------------------------------------------------------------Hypertriglyceridemia is the most difficult lipid disorder to evaluate and treat. Hypertriglyceridemic disorder in adults is not a single gene. We do not know if TGs by themselves are an atherogenic risk or is it because of the company they keep.The intra-individual biological variability (diurnal and monthly) of lipids make it more difficult to define hypertriglyceridemia.TGs are inversely associated with HDL-C, if high HDL-C levels, almost always TGs are low.Dietary treatment of severe hypertriglyceridemia: <5%, no alcohol, discontinue all TG-lowering drugs, monitor TG q 3 days until levels are below 1000, then restart treatment.Fibrates do not reduce the CHD events in high risk patient groups. What impact hypertriglyceridemia has on CHD outcomes is not yet clear.Lower fasting TG to less than 500 mg/dL; this will reduce the risk of pancreatitis.Follow the current guideline recommendations to lower LDL-C.The real value of Apo-B is in patients who do not have raised LDL-C (<100 mg/dL). In such patients it can be very informative and should be taken as an indicator of CVD risk.Plasma apoB and the other cholesterol indexes are complementary rather than competitive indexes of atherosclerotic risk (Am J Cardiol. 2003 May 15;91(10):1173).Baseline TGs are determinants of the response to bezafibrate (BIP trial).Omega-3 fatty acids are beneficial in reducing CV risk (JELIS; Lancet 2007), especially in patients with high TG and low HDL-C (Atherosclerosis. 2008).If fasting TG is >200 mg/dL and HDL-C <35 mg/dL, consider a fibrate or omega-3 fatty acid.

Worry can creat many other problems cancer can happen otherwise also to anybody there is nothing like pcos patients will have cancer in the long run but take your treatment for it as well as thyroid seriously.

Cholesterol level should be measured at least once every five years in everyone over age 20. The screening test that is usually performed is a blood test called a lipid profile. Experts recommend that men ages 35 and older and women ages 45 and older be more frequently screened for lipid disorders. The lipoprotein profile includes:
Total cholesetrol
LDL (low-density lipoprotein CHOLESETROL also called "bad"CHOLESTETROL
HDL (high-density lipoprotein cholesterol, also called "good" cholesterol)
TRIGLYCERIDES (fats carried in the BLOOD from the food we eat. Excess calories, alcohol, or sugar in the body are converted into TRIGLYCERIDES and stored in fat cells throughout the body.
High triglycerides and cholesterol can cause atherosclerotic heart disease or narrowed coronary arteries in the heart can cause the symptoms of angina, when theheart muscle is not provided with enough oxygen to function.
Decreased blood supply to the brain may be due to narrowed small arteries in the brain or because the larger carotidarteries in the neck may become blocked. This can result in a transient ischmic attack or stroke.
Peripheral artery disease describes gradual narrowing of the arteries that supply the legs. During exercise , if the legs do not get enough blood supply, they can develop pain , called claudication .
Other arteries in the body may also be affected by plaque buildup causing them to narrow, including the mesenteric arteries to the intestine and the renal arteries to the kidney.
Change life style .do meditation,yoga, Go walk daily, do any one physically activity daily i.e.play any game., Avoid fast foods,oily foods,junk foods,alcohol,smoking,fatty foods, non-veg.,avoid stress,take plenty of water in day time. And 1 glass of water before bed at night.
use flax oil, omega-3 fatty meal or cap., take .green veg., whole grain.
GARLIC,. Cod liver oil.
Take anti cholesterol medicines .
Cap. Ecosprin gold-10 at night daily.
caciral sachet once a week up to 6 weeks.

Hi lybrate-user, normal range is in fasting 90mg/do and post lunch120mg/dl. But as the fluctuations are common in this you need to do monthly once that will be sufficient. Go for hba1c test to know accurately.

Yes overweight or obese people have a higher risk of developing diabetes. Most patients do not have any symptoms. However, there may be excessive thirst or urination or recurrent infections. Only way to confirm is checking sugars at least once a year.

Your tsh levels are normal, & b12 levels are just above the minimal. If you have no symptoms of any kind then need not worry. But if you feel may take mego tablets daily one for a few days to prop up b12 level.

Mr. Lybrate-user to control diabetes you have to do following things:
1) take appropriate medication regularly without missing a dose, 2) take a restricted diet, that gives exact calories based on ideal body weight, blood sugar levels and extent of daily physical activity. 3) do a periodic checking of blood sugar initially more often later once in 15 days or once a month. 4) exercise daily for at least 1 hour a day so as to spend more calories, avoid weight increase and have a feeling of well being.